Effects of Mechanical Insufflation-Exsufflation With Different Pressure Settings on Respiratory Mucus Displacement During Invasive Ventilation

Joan-Daniel Martí, Roberto Martínez-Alejos, Xabier Pilar-Diaz, Hua Yang, Francesco Pagliara, Denise Battaglini, Andrea Meli, Milan Yang, Joaquim Bobi, Monsterrat Rigol, Oystein Tronstad, Marcia Souza Volpe, Marcelo Britto Passos Amato, Gianluigi Li Bassi and Antoni Torres. Respiratory Care DOI 10.4187/respcare.10173

BACKGROUND: Mechanical insufflation-exsufflation (MI-E) has been proposed as a potential strategy to generate high expiratory flows and simulate cough in the critically ill. However, efficacy and safety of MI-E during invasive mechanical ventilation are still to be fully elucidated. This study in intubated and mechanically ventilated pigs aimed to evaluate the effects of 8 combinations of insufflation-exsufflation pressures during MI-E on mucus displacement, respiratory flows, as well as respiratory mechanics and hemodynamics.